Organization Active NPI

Larry J Assalita

  • Durable Medical Equipment & Medical Supplies
  • State College, PA
National Provider Identifier
1669656419
Registry record updated Oct 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
SC002410-L Issued in PA
Legal business name
LARRY J ASSALITA
Practice address
110 Regent CT
Suite 200
State College, PA 16801-7966
Phone
(814) 238-0675
Fax
(814) 238-8455
NPI assigned
Dec 27, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Larry J Assalita, DPM
Title
Proprietor
Phone
(814) 238-0675

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X SC002410-L PA Primary
Customized Equipment (DME) 332BC3200X SC002410-L PA

Addresses

Primary practice location

110 Regent CT
Suite 200
State College, PA 16801-7966

Mailing address

110 Regent CT
Suite 200
State College, PA 16801-7966
Phone (814) 238-0675

Other identifiers 2

IdentifierTypeStateIssuer
0867765MedicaidPA
862816801OtherTRICARE

National Provider Directory

National Provider Directory

Locations

110 Regent Ct
Ste 200
State College, PA 16801
Phone (814) 238-0675

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1198713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1351123200000",
    "number": "1669656419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 REGENT CT",
            "address_2": "SUITE 200",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168017966",
            "telephone_number": "814-238-0675",
            "fax_number": "814-238-8455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 REGENT CT",
            "address_2": "SUITE 200",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168017966",
            "telephone_number": "814-238-0675",
            "fax_number": "814-238-8455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LARRY J ASSALITA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-27",
        "last_updated": "2012-10-25",
        "status": "A",
        "authorized_official_last_name": "ASSALITA",
        "authorized_official_first_name": "LARRY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PROPRIETOR",
        "authorized_official_telephone_number": "814-238-0675",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "PA",
            "license": "SC002410-L",
            "primary": true
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "PA",
            "license": "SC002410-L",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0867765",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "862816801",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in State College, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.